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ICD-10 Readiness

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By Jean Scharfenkamp, RHIA

When CMS published the ICD-10-CM/PCS Final Rule in January 2009, there were 58 months' lead time to prepare for the rule's October 2013 effective date.  A third of those months have passed.

To review:

  • On October 1, 2013, ICD-10-CM/PCS will replace ICD-9-CM for codes for medical diagnoses and inpatient procedures.
  • ICD-10-CM/PCS has two components--ICD-10-CM for diagnosis coding by all providers and ICD-10-PCS for inpatient procedures.
  • Electronic claims must transition to Version 5010 on January 1, 2012.

Many features of ICD-10-CM/PCS will be welcome, such as the ability to report left, right or bilateral sites of injury as well as separate encounters of care. ICD-10-CM also provides for specific clinical information within code sets that will help eliminate the need for additional documentation to substantiate provider billing. ICD-10-CM allows for the expansion of codes related to postoperative complications, substance abuse and injuries.

Key preparatory steps include:

  • Developing awareness within your entire organization
  • Creation of a multidisciplinary steering committee
  • Detailed analysis by each functional area of needs, opportunities and challenges
  • Staff responsible for assigning medical codes will need formal training to prepare for the multitude of differences between ICD-9-CM and ICD-10-CM/PCS, including increased biomedical knowledge required for correct assignment of codes. The American Health Information Management Association (AHIMA) estimates time needed for training and practice will be approximately 26 hours for ICD-10-CM and 34 hours for ICD-10-PCS.

There is still time to take advantage of the ICD-10-CM/PCS implementation timeframes.  Resources are available through many websites that can assist you through the ICD-10-CM/PCS transition: